FOR IMMEDIATE RELEASE
Monday, June 08, 2009
Study Finds Medicaid Managed Care Organization Leads Massachusetts in Payer Performance
Network Health ranked #1 payer among Massachusetts Medicaid Managed Care Organizations
by lowering unnecessary claim denials and reducing medical documentation
(Medford, Mass.) — A recent study released by athenahealth, Inc., a provider of Internet-based business services to physician practices, ranked Network Health as the top payer among Massachusetts Medicaid Managed Care Organizations (MMCOs) and the second-highest performer among all Massachusetts health plans.
The study by athenahealth is considered significant because it brings visibility to payer performance and automation, and identifies opportunities to improve process gaps, and create administrative efficiencies. According to the study’s findings, Network Health excelled in promptly approving accurate provider claims and decreasing the number of claims requiring costly follow-up documentation.
“Network Health is pleased because the results highlight the rigorous management practices and continuous quality improvement measures we utilize every day,” said Christina Severin, president of Network Health. “Efficiency plays a crucial role in every health plan’s ability to process claims quickly and accurately.”
athenahealth’s findings is the latest example of efficiencies Network Health employs. In February, the Massachusetts Division of Health Care Finance and Policy released a list of key indicators that showed Network Health maintains the lowest administrative expense ratio of any Massachusetts health plan.
Network Health’s focus on efficiency illustrates the value MMCOs bring to Massachusetts. Through continuous quality improvements and a focus on electronic processing options, Network Health uses public resources wisely and furthers its mission of increasing access to health care among low- and moderate-income Massachusetts residents.
About Network Health
Since 1997, Network Health has provided access to high-quality health care to low- and moderate-income residents of Massachusetts. Based in Medford, Mass., Network Health is a comprehensive health plan serving members through its Network Health Together™ (MassHealth) and Network Health Forward™ (Commonwealth Care) plans.
Network Health provides its Together members with all the benefits of MassHealth, plus additional free and discounted benefits. Network Health’s Commonwealth Care plan extends access to affordable health care for qualified Massachusetts residents 19 years or older who earn at or below 300 percent of the federal poverty level, or up to approximately $32,496 a year for an individual (up to approximately $66,156 a year for a family of four). In addition to core health care benefits, Network Health offers its Forward members extra benefits designed to encourage wellness.
Network Health is nationally recognized for its integrated model of care, which provides a team of in-house medical, mental health, social service, and pharmacy professionals to coordinate the care of members with complex health needs and address their non-medical barriers to care. In its efforts to improve the health and well-being of its members and their diverse communities, Network Health partners with a growing network of nearly 18,000 primary care providers, specialists, hospitals, and community organizations to serve members in more than 300 cities and towns across Massachusetts.
Individuals must be eligible for MassHealth to join Network Health Together, a MassHealth plan. To learn about MassHealth eligibility, Massachusetts residents can contact the MassHealth Enrollment Center at 888-665-9993 (TTY: 888-665-9997), Monday through Friday, 8:45 a.m. to 5 p.m. Once enrolled, MassHealth members can learn about their MassHealth health plan options by calling the MassHealth Customer Service Center at 800-841-2900 (TTY: 800-497-4648), Monday through Friday, 8 a.m. to 5 p.m.
To learn about Commonwealth Care health plan options, call the Commonwealth Care Customer Service Center at 877-MA-ENROLL or 877-623-6765 (TTY: 877-623-7773), Monday through Friday, 8 a.m. to 5 p.m. Or visit www.mahealthconnector.org.
###